| NPI | 1780332700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY SUE MALMON Owner 952-800-9620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-03-17 |
| Last Update Date | 2022-03-17 |